[问卷在孕期各孕周阻塞性睡眠呼吸暂停低通气综合征筛查中的应用价值]
[Application value of questionnaires in the screening obstructive sleep apnea syndrome in pregnancy across trimesters].
作者信息
Wang J Y, Xiao W H, Zhang L Y, Zhang C, Wei J, Yang J J, Zhou B, Zhao L, Zhang X L, Xu L Y, Hong S D, Dong X S, Liu G L
机构信息
Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China.
Department of Respiratory Medicine and Intensive Care Unit, Binzhou Medical University Hospital, Binzhou 256603, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2023 Dec 26;103(48):3932-3937. doi: 10.3760/cma.j.cn112137-20230726-00096.
To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.
评估柏林问卷、STOP问卷、STOP - Bang问卷（SBQ）、爱泼沃斯思睡量表（ESS）在筛查不同孕期孕妇阻塞性睡眠呼吸暂停低通气综合征（OSAS）中的临床应用价值。2021年1月至2022年4月，在北京大学人民医院产科门诊纳入连续的OSAS高危孕妇。她们完成了柏林问卷、STOP问卷、SBQ问卷、ESS问卷，并接受了整夜多导睡眠图（PSG）检查。为评估柏林问卷、STOP问卷、SBQ问卷、ESS问卷的准确性，计算这些问卷在孕期各阶段（妊娠1 - 15周为第一阶段，妊娠16 - 27周为第二阶段，妊娠28 - 40周为第三阶段）的敏感度、特异度、阳性预测值、阴性预测值以及受试者工作特征（ROC）曲线下面积（AUC）。本研究共纳入100名孕妇[年龄（34.5±4.3）岁（26 - 46岁）]，其中妊娠第一、二、三期分别为20名、35名和45名孕妇。根据PSG结果，100名孕妇中有45名（45%）被诊断为OSAS。四项问卷的总体预测价值不佳，ESS问卷、柏林问卷、STOP问卷和SBQ问卷的ROC曲线下面积[AUC（95%）]分别为0.54（0.43，0.66）、0.59（0.47，0.70）、0.62（0.51，0.73）和0.61（0.49，0.72）；敏感度分别为35.6%、65.9%、48.9%、28.9%；特异度分别为71.7%、52.5%、73.6%、92.5%。按孕期分类时，四项问卷的预测值在妊娠第一期升高，STOP问卷的AUC（95%）为0.81（0.61，1.00），敏感度为75.0%，特异度为87.5%。四项筛查问卷对孕妇的总体预测能力有限。但STOP问卷在妊娠第一期的预测价值尚可。
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